Children from the most deprived areas are four times more likely to die from an asthma attack, a charity has warned.
Asthma + Lung UK called on the Government to take ‘urgent action’ to prevent child asthma deaths including tackling poor housing conditions and air pollution.
It comes as the National Child Mortality Database Report on Child Deaths Caused by Asthma shows that between April 2019 and March 2023, 54 children died due to asthma – one every four weeks.
More than half – 56% – of the children who died came from the poorest communities.
Well-known risk factors for asthma attacks were common in a high proportion of the deaths, including overuse of reliever inhalers, emergency hospital admissions, and exposure to air pollution and cigarette smoke, the report said.
It found 87% of the children had three or more SABA inhalers dispensed in the year before their death with half of them having 12 or more.
In addition, 65% had attended an emergency department or had an emergency admission in the year before death.
All the children who died lived in areas with air pollution above levels recommended by the World Health Organisation.
And smoking by family members was recorded in nearly half (43%) of the cases despite the national average of adults who smoke in the UK being 13%.
Reviews of the deaths had documented multiple missed appointments for asthma reviews over many years, with primary, secondary and tertiary care, and with children discharged from services.
Poor compliance with preventer medication was also documented and there were examples of children who were managing their asthma without adult oversight, the report found.
There were also examples of services failing to follow up and escalate appropriately, including SABA inhalers frequently prescribed by GPs despite children not being brought for reviews.
In some cases, healthcare professionals repeatedly referred children to social care due to missed appointments and non-compliance with treatment, stating their concerns about risk of significant harm and death but this was not followed up.
Asthma + Lung UK said there was a ‘pressing need’ to do more to protect the 1.75 million children in England with the condition and called on the Government to ensure proper implementation of the new UK-wide joint BTS/NICE/SIGN asthma guidelines.
This should include provision of basic care in the community, including accurate diagnosis and annual reviews that include an inhaler technique check and written action plan.
Sarah Sleet, chief executive at Asthma + Lung UK, said: ‘A child dying from asthma every month is devastating and unacceptable.
‘More than a decade after the National Review of Asthma Deaths found that two thirds of asthma deaths are avoidable, people with asthma are still not getting the basic care they need and those living in the most deprived parts of the country are most at risk.
‘Bridging this health gap will only be possible if politicians commit to preventing poor lung health in the first place. This means action to cut smoking rates, tackle air pollution, and address issues such as poor housing.’
Dr Andy Whittamore, a GP and clinical lead at Asthma + Lung UK, said: ‘Every week I speak to families who are powerless to change the things making their child’s asthma worse, such as living in damp, mouldy housing, or near busy polluted roads.
‘For children from the poorest communities, their chance of good health is determined almost before they’re born. That has to change.’
He added: ‘The new asthma guidelines offer some hope. Recommendations for better treatments and closer follow-up after a flare-up have the potential to keep children with asthma safe.
‘But without adequate funding and an NHS workforce fully upskilled in asthma care, properly implementing them will be impossible.’
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